title: Stepwise relationship between components of metabolic syndrome and risk of colorectal adenoma in a Taiwanese population receiving screening colonoscopy.
abstract: OBJECTIVE
  Metabolic syndrome (MS) is a cluster of diseases related to insulin resistance and is an important cardiovascular risk factor. In addition, MS has been linked to some malignancies, including colorectal cancer. Colon adenoma is a well-established pre-malignant lesion of colorectal cancer. The aim of this study was to determine the effect of various components of MS on the risk of colorectal adenoma.
  
  
  METHODS
  From October 2004 to April 2006, 3106 subjects who had undergone complete colonoscopy for health examinations at the hospital were enrolled. MS was defined according to the modified National Cholesterol Education Program Adult Treatment Panel III definition for South Asians and Chinese. Multivariate logistic regression was used to analyze the association between components of MS and colorectal adenoma.
  
  
  RESULTS
  Of the 3106 subjects, the mean age was 47.1 ± 10.8 years and there were 397 (13%) subjects with pathologically proven colorectal adenoma. Male sex, old age (=50 years), current smokers, and abdominal obesity were associated with increasing risk of colorectal adenoma. MS was associated with increased risk of colorectal adenoma (odds ratio: 1.71, 95% confidence interval: 1.34-2.71), and this risk increased with the number of metabolic components. Multiple and synchronous adenomas of the proximal and distal colon were positively associated with MS.
  
  
  CONCLUSIONS
  Subjects with metabolic syndrome have increased risk of developing colorectal adenoma. Screening colonoscopy for prevention of colorectal adenoma might be warranted when abdominal obesity or more than three components of MS are present.
authors.affiliation: Department of Family Medicine, Shin Kong Wu Ho-Su Memorial Hospital, 95 Wen Chang Road, Shih Lin, Taipei 111, Taiwan.
authors.forename: Nien-Chih
authors.initials: NC
authors.lastname: Hu
authors.forename: Jong-Dar
authors.initials: JD
authors.lastname: Chen
authors.forename: Yu-Min
authors.initials: YM
authors.lastname: Lin
authors.forename: Jun-Yih
authors.initials: JY
authors.lastname: Chang
authors.forename: Yu-Hung
authors.initials: YH
authors.lastname: Chen
mesh_terms: D000236:Adenoma / Q000453:epidemiology* / Q000473:pathology; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D044466:Asian People; D002318:Cardiovascular Diseases / Q000150:complications; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000473:pathology; D003111:Colonic Polyps / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D003113:Colonoscopy; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000208:ethnology*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012004:Rectal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult